Rationale and Design of the British Heart Foundation (BHF) coronary microvascular function and CT coronary angiogram (CorCTCA) study

Publication date: Available online 2 December 2019Source: American Heart JournalAuthor(s): Novalia P Sidik, Margaret McEntegart, Giles Roditi, Thomas J Ford, Michael McDermott, Andrew Morrow, John Byrne, Jacqueline Adams, Allister Hargreaves, Keith G Oldroyd, David Stobo, Olivia Wu, Claudia-Martina Messow, Alex McConnachie, Colin BerryBackgroundMicrovascular and/or vasospastic angina are relevant causes of ischemia and no obstructive coronary artery disease (INOCA) in patients after computed tomography coronary angiography (CTCA).ObjectivesOur research has two objectives. The first is to undertake a diagnostic study and the second is to undertake a nested, clinical trial of stratified medicine.DesignA prospective, multicenter, randomized, blinded, sham-controlled trial of stratified medicine (NCT03477890). All-comers referred for clinically-indicated CTCA for investigation of suspected coronary artery disease (CAD) will be screened in 3 regional centers. Following informed consent, eligible patients with angina symptoms are enrolled before CTCA and remain eligible if CTCA excludes obstructive CAD.Diagnostic study: Invasive coronary angiography involving an interventional diagnostic procedure (IDP) to assess for disease endotypes: 1. Angina due to obstructive CAD (fractional flow reserve (FFR) ≤0.80); 2. Microvascular angina (coronary flow reserve (CFR) <2.0 and/or index of microvascular resistance (IMR)>25); 3. Microvascular angina due to small vessel spasm (acetylcholi...
Source: American Heart Journal - Category: Cardiology Source Type: research